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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Reference Ranges of Left Ventricular Hemodynamic Forces in Healthy Adults: A Speckle-Tracking Echocardiographic Study
Francesco Ferrara1, Francesco Capuano2, Rosangela Cocchia3
1Cardio-Thoracic-Vascular Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", 84125 Salerno, Italy.
Insights
This study defines the normal range for left ventricular (LV) hemodynamic forces (HDFs) in healthy adults. Understanding these HDFs and their correlates can improve assessments of LV function in clinical practice.
Area of Science:
- Cardiology
- Biomedical Engineering
- Physiology
Background:
- Normal limits of left ventricular (LV) hemodynamic forces (HDFs) are not well-established.
- Assessing LV function relies on understanding normal HDF parameters.
Purpose of the Study:
- To explore the full spectrum of HDF parameters in healthy subjects.
- To determine the physiologic correlates of HDFs in a healthy population.
Main Methods:
- 269 healthy subjects underwent echo-Doppler examination.
- Tri-plane tissue tracking measured 2D global endocardial longitudinal strain (GLS), circumferential strain (GCS), and LV HDFs.
- HDFs were normalized by LV volume and body weight.
Main Results:
- LV systolic longitudinal HDFs were higher in men compared to women.
- Age showed a significant inverse correlation with GCS and LV longitudinal HDFs.
- Multivariable analysis identified age, BSA, pulse pressure, heart rate, and GCS as independent predictors of LV HDFs.
Conclusions:
- This study reports the physiologic range of LV HDFs.
- Establishing reference values for HDFs may facilitate their clinical use.
- This knowledge can lead to a more comprehensive assessment of LV function.
Background:
The normal limits of left ventricular (LV) hemodynamic forces (HDFs) are not exactly known. The aim of this study was to explore the full spectrum of HDF parameters in healthy subjects and determine their physiologic correlates.
Methods:
269 healthy subjects were enrolled (mean age: 43 ± 14 years; 123 (45.7%) men). All participants underwent an echo-Doppler examination. Tri-plane tissue tracking from apical views was used to measure 2D global endocardial longitudinal strain (GLS), circumferential strain (GCS), and LV HDFs. HDFs were normalized with LV volume and divided by specific weight.
Results:
LV systolic longitudinal HDFs (%) were higher in men (20.8 ± 6.5 vs. 18.9 ± 5.6, p = 0.009; 22.0 ± 6.7 vs. 19.8 ± 5.6, p = 0.004, respectively). There was a significant correlation between GCS (increased) (r = -0.240, p < 0.001) and LV longitudinal HDFs (reduced) (r = -0.155, p = 0.01) with age. In a multivariable analysis age, BSA, pulse pressure, heart rate and GCS were the only independent variables associated with LV HDFs (β coefficient = -0.232, p < 0.001; 0.149, p = 0.003; 0.186, p < 0.001; 0.396, p < 0.001; -0.328, p < 0.001; respectively).
Conclusion:
We report on the physiologic range of LV HDFs. Knowledge of reference values of HDFs may prompt their implementation into clinical routine and allow a more comprehensive assessment of the LV function.
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